title: Surgical procedures and prognostic factors for local recurrence of soft tissue sarcomas.
abstract: BACKGROUND
  Patients with local recurrence of soft tissue sarcomas are predisposed to future recurrences because treatment is challenging and complicated by prior therapy. This study investigated clinical outcomes following surgical procedures for locally recurrent soft tissue sarcomas and risk factors for re-recurrence and metastasis.
  
  
  METHODS
  A retrospective analysis was conducted with 105 patients (52 males, 53 females) who underwent surgical procedures for local recurrence without distant metastasis of soft tissue sarcoma between 1987 and 2009. Patient follow-up ranged from 1 to 12 years (mean 4.9 years).
  
  
  RESULTS
  Overall 5- and 10-year survival rates were 83.4 and 67.7%, respectively. Twenty-one patients (20.0%) had additional local recurrences, and 23 (21.9%) had distant metastases. Amputation rate was 10.5% at the time of surgical procedures and 17.1% at final follow-up. Locations deep within muscles in the upper limb or trunk and surgical margins <1 cm wide were risk factors for further local recurrence. Locations deep within muscles, tumor sizes >10 cm, high-grade malignancy, and local recurrence after radical surgery were risk factors for distant metastasis.
  
  
  CONCLUSIONS
  Surgical margin and location were independent prognostic factors for local control, and a wider margin was especially important for recurrent tumors located in the trunk and upper extremity. For high-grade sarcomas with local recurrence after radical surgery, new approaches are needed to prevent distant metastases.
authors.affiliation: Department of Orthopaedic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan, shidesh3@aichi-cc.jp.
authors.forename: Hideshi
authors.initials: H
authors.lastname: Sugiura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishida
authors.forename: Hiroatsu
authors.initials: H
authors.lastname: Nakashima
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsukushi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D004210:Dissection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult